| NPI | 1639309156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301094833) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA 136961) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2015-07-06 |